Shaken Baby Syndrome by Dr. Narmin Azizova
Dr. Narmin Azizova, Neonatologist, Department of Neonatal Resuscitation and Intensive Therapy, Scientific Research Institute of Pediatrics named after K.Y. Farajova; Department of Pediatrics I, Azerbaijan Medical University; Founder, Pediatriya.az
What is Shaken Baby Syndrome?
Shaken Baby Syndrome occurs as a result of violently shaking an infant or young child. This condition can lead to serious brain injuries such as brain swelling, intracranial bleeding, skull fractures, retinal hemorrhages, and in severe cases, death.
Shaken Baby Syndrome is mainly observed in children under the age of two, particularly in infants under six months. However, it can also occur in children up to five years old. While early diagnosis of mild cases can be difficult, the symptoms of severe cases are usually quickly identifiable.
Why are Infants More Vulnerable to Shaken Baby Syndrome?
Infants and young children have unique anatomical and physiological features that make them particularly susceptible to brain injury from shaking:
- Their skull bones are softer and thinner, which allows the brain to move more freely within the skull.
- The baby’s head is disproportionately larger compared to the rest of the body, making up about 10% of their total body weight.
- The brain is not fully developed, and myelination is incomplete.
- The neck muscles are weak, making it difficult to control head movement.
When an infant is violently shaken, their delicate brain moves back and forth inside the skull, leading to bruising, swelling, and bleeding. As a result, severe neurological damage or even death can occur.
Causes of Shaken Baby Syndrome
Shaken Baby Syndrome mainly occurs due to violent shaking. The factors that contribute to this syndrome include:
- Young or inexperienced parents who may not have enough knowledge about infant care.
- Postpartum depression in mothers.
- Parents or caregivers who have experienced violence themselves.
- Stressful situations such as financial difficulties, lack of social support, and fatigue.
- Misunderstandings about normal infant behavior, especially prolonged crying.
However, Shaken Baby Syndrome is not only caused by intentional violence. Activities that seem harmless, such as throwing a baby in the air, excessive rocking, or shaking the child forcefully, can also result in brain injury. Given that such “affectionate methods” of handling babies are quite common in our country, it is likely that there are many infants suffering from this syndrome.
Symptoms of Shaken Baby Syndrome
The symptoms of Shaken Baby Syndrome can vary from mild to severe and may include:
- Seizures;
- Difficulty waking up or unconsciousness;
- Vomiting;
- Poor feeding and loss of appetite;
- Breathing difficulties or problems with respiration;
- Changes in skin color (paleness or bruising);
- Paralysis;
- Vision problems or blindness.
Doctors look for three main clinical signs in diagnosing Shaken Baby Syndrome:
- Subdural or subarachnoid hemorrhages (brain bleeding);
- Retinal hemorrhages (eye bleeding);
- Cases with minimal or no external trauma.
Diagnosis of Shaken Baby Syndrome
The diagnosis of Shaken Baby Syndrome includes the following methods:
- Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans to detect brain injury;
- Eye exams to detect retinal hemorrhages;
- X-rays to check for fractures;
- Blood tests to rule out other conditions that may cause similar symptoms.
Some symptoms may not appear immediately after the shaking but may develop over time.
Long-Term Consequences of Shaken Baby Syndrome
Shaken Baby Syndrome can cause serious and permanent complications, including:
- Severe brain injury and permanent disabilities;
- Spinal cord injuries leading to paralysis;
- Vision problems, including blindness;
- Cognitive and motor delays;
- Fractures or joint dislocations;
- Intellectual disabilities.
Prevention and Education for Shaken Baby Syndrome
According to the World Health Organization (WHO), Shaken Baby Syndrome is recognized as a public health issue. Thousands of infants around the world suffer injuries related to Shaken Baby Syndrome, leading to severe disabilities or death.
Prevention of Shaken Baby Syndrome requires education and support. Key strategies include:
- Educating parents and caregivers;
- Promoting stress management techniques;
- Providing information on safe handling of infants;
- Organizing public health campaigns.
Shaken Baby Syndrome is a serious condition that can lead to permanent damage or even death due to strong physical impact on the child’s head. As Pediatriya.az, we strongly recommend that parents and caregivers refrain from using any physical violence on children and ensure their development is supported in a safe environment.